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目的 探讨帕金森病合并轻度认知障碍( Parkinson’s disease with mild cognitive impair-ment,PD-MCI)患者脑结构网络的改变,为临床上早期识别PD-MCI提供新的标记物.方法 收集2017年5月至2018年5月徐州医科大学附属医院神经内科门诊和住院的原发性PD患者47例,选择同期24例健康志愿者作为对照组(healthy control,HC).收集所有受试者一般人口统计学资料,并对所有受试者的总体认知功能以及五个认知区域(注意与工作记忆、执行功能、语言、记忆及视空间功能)进行全面评估,PD组根据其认知评估结果进一步分为PD-MCI组(n=22)和PD-NC组(n=25).所有受试者完成弥散张量成像(DTI)扫描并通过确定性弥散张量示踪法获得每个受试者的脑结构网络,利用图论分析技术在网络属性(全局属性和节点属性)、枢纽节点分布及网络连边的水平评估3组间的网络结构连接差异.结果 与PD-NC和HC组相比,PD-MCI组特征路径增加[ PD-NC组:(8. 33±0. 95),HC组:(8. 18±1. 35),PD-MCI组:(9. 20±1. 52),F=4. 14,P<0. 05],全局效率下降[PD-NC组:(0. 13±0. 05),HC组:(0. 13±0. 04),PD-MCI组:(0. 10±0. 04),F=3. 73,P<0. 05],额顶叶、丘脑、扣带回和岛叶节点效率降低(P=0. 003~0. 040,FDR校正).与HC组相比,PD-MCI组在额顶颞区、基底神经节和岛叶网络连接强度降低(P<0. 05,FDR校正);与PD-NC组相比,PD-MCI组在额顶区网络连接强度降低(P<0. 05,FDR校正).结论 构成大脑网络的结构连接中断可导致信息整合和传递发生改变,从而引起认知功能障碍.脑结构网络属性及连边改变的分布和模式有望成为识别PD-MCI的新标记物.“,”Objective To explore the changes of brain structure network in patients with Parkinson’s disease with mild cognitive impairment(PD-MCI),and to provide novel markers for the early recognition of PD-MCI. Methods Total 47 patients with primary PD were continuously enrolled at the De-partment of Neurology,Affiliated Hospital of Xuzhou Medical University from May 2017 to May 2018. Twenty-four healthy volunteers were selected as the healthy control (HC) group. General demographic data were col-lected from all subjects. The overall cognitive function and the five cognitive domains (attention and working memory,executive function,language,memory and visual spatial function) were comprehensively evaluated, then the patients with PD were further divided into PD-MCI group(n=22) and PD-NC group(n=25) based on their cognitive evaluation results. All subjects completed the diffusion tensor imaging( DTI) scan and the individual structural brain connection was obtained by deterministic diffusion-tensor tractography. By graph theory analysis technology,the network properties (global properties and node properties) and edge-wise dis- tributions were compared to assess structural connectivity differences among the three groups. Results Com-pared with the PD-NC and HC groups,the PD-MCI group had a larger characteristic path length(PD-NC:(8. 33±0. 95),HC:(8. 18±1. 35),PD-MCI:(9. 20±1. 52),F=4. 14,P<0. 05) and reduced global efficien-cy (PD-NC:(0. 13±0. 05),HC:(0. 13±0. 04),PD-MCI:(0. 10±0. 04),F=3. 73,P<0. 05) in addition to a lower nodal efficiency in frontoparietal areas,thalamus,cingulate gyrus,and insular(P=0 . 003-0. 040,FDR correction). Compared with the HC group,the PD-MCI group had a large frontotemporoparietal areas,basal ganglia,and insular network with decreased connection strength (P<0. 05,FDR correction). Compared with the PD-NC group,the PD-MCI group had a lower network connection strength in the frontoparietal areas (P<0. 05,FDR correction). Conclusion A disruption of structural connections that make up the brain network can lead to changes in information integration and delivery,leading to cognitive dysfunction in patients with PD. The distribution pattern of brain network structure connection changes is expected to become a new marker for identifying PD-MCI.